Neurophysiologic cut off values for safe resection of patients with supratentorial gliomas.

BACKGROUND: Gliomas have infiltrative nature and tumor volume has direct prognostic value. Optimal resection limits delineated by high-frequency monopolar stimulation with multipulse short train technique is still a matter of debate for safe surgery without (or with acceptable) neurological deficits. It is also an enigma whether the same cut-off values are valid for high and low grades. We aimed to analyze the value of motor mapping/monitoring findings on postoperative motor outcome in diffuse glioma surgery. METHODS: Patients who were operated on due to glioma with intraoperative neuromonitorization at our institution between 2017 and 2021 were analyzed. Demographic information, pre- and post-operative neurological deficit, magnetic resonance images, resection rates, and motor evoked potential (MEP) findings were analyzed. RESULTS: Eighty-seven patients of whom 55 had high-grade tumors were included in the study. Total/near-total resection was achieved in 85%. Subcortical motor threshold (ScMTh) from resection cavity to the corticospinal tract was ≤ 2mA in 17; 3 mA in 14; 4 mA in 6; 5 mA in 7, and ≥5mA in 50 patients. On the 6th month examination, six patients (5 with high-grade tumor) had motor deficits. These patients had changes in MEP that exceeded critical threshold during monitoring. Receiver operating characteristic analysis revealed 2.5 mA ScMTh as the cut-off point for limb paresis after awakening and 6 months for the groups. CONCLUSIONS: Subcortical mapping with MEP monitoring helps to achieve safe wider resection. The optimal safe limit for SCMTh was determined as 2.5 mA. Provided that safe threshold values are maintained in MEP, surgeon may force the functional limits by lowering the SCMTh to 1 mA, especially in low-grade gliomas.

Survival of root canal-treated teeth adjacent to an implant: A retrospective case-control study.

OBJECTIVES: To evaluate the survival of root canal treated (RCT) teeth adjacent to an implant compared with that of RCT teeth of the same patient non-adjacent to an implant. MATERIALS AND METHODS: RCT tooth of each patient adjacent to an implant were included in the test group. The control group consisted of another RCT tooth of the same patient; the control RCT tooth was not adjacent to an implant and selected to be of the same type of the RCT tooth in the test group. 72 teeth of 36 patients with at least 4-year follow-up were included. In addition to survival, other clinical and demographic parameters investigated were age, sex, tooth type and position, presence of a crown, presence of retreatment, presence of a post-core, presence of adjacent edentulous area, presence of implant-supported fixed prosthetic restoration on the antagonist tooth and periapical health status. Pearson Chi-Square and Fisher Exact tests were used to compare the test and the control groups with categorical variables (α=0.05). Survival curves were obtained by the Kaplan-Meier method, and the Log-rank test was performed to compare the survival probabilities (α=0.05). RESULTS: No significant difference in survival rates was observed between the test and the control groups (p = 0.72). Similarly, no significant relationship was found between the investigated clinical variables and the survival rates of RCT teeth (p>0.05). Survival times differed depending on the presence of an adjacent edentulous area (p<0.001) and the periapical health status (p = 0.026). CONCLUSIONS: RCT teeth with unhealed periapical tissues had a shorter cumulative survival time. Similarly, those adjacent to an edentulous area had shorter cumulative and complication-free survival times. CLINICAL SIGNIFICANCE: This is the first study to determine the survival outcome of a RCT tooth adjacent to an implant compared to a non-adjacent one in the same patient. Being adjacent to an implant did not have a detrimental effect on the survival time and rate of RCT teeth.

Anthelmintic effects of peppermint (Mentha piperita), lemon (Citrus limon), and tea tree (Melaleuca alternifolia) essential oils against Monogenean parasite (Dactylogyrus sp.) on carp (Cyprinus carpio).

Dactylogyrus sp. (Monogenea) is one of the most dangerous pathogens causing parasitic infections in carp (Cyprinus carpio) and other freshwater fish. Due to the adverse effects of conventional chemical treatments on the environment and fish, the use of herbal products in aquaculture against various diseases has increased. In the present study, anthelmintic effects of peppermint (Mentha piperita), lemon (Citrus limon), and tea tree (Melaleuca alternifolia) essential oils against Dactylogyrus sp. found on the gills of carp were studied using in vitro and in vivo experiments. In in vitro experiments, 1, 2.5, 5, and 10 µl/ml concentrations of these essential oils were tested on the parasites and cumulative mortalities were observed to reach 100 % after treatment with peppermint, lemon, and tea tree essential oils of 1 µl/ml concentration in approximately 15, 10 and 2 min, respectively. The in vitro experiments demonstrated that the cumulative mortality of the parasites increased with essential oil concentration and exposure duration. As the concentration of essential oil used increased, the observed mean time to death of parasites decreased. In in vivo experiments, median effective concentrations (EC50) as assessed by in vitro tests for peppermint and lemon essential oils in 5 min exposure and EC50 concentration for tea tree essential oil in 2 min exposure was applied on fish as a single bath and there was a significant decrease in the mean parasite intensities (p<0.05). Antiparasitic efficacies of peppermint, lemon, and tea tree essential oils were determined as 28.23 %, 30.95 %, and 35.31 %, respectively. The tea tree oil was the most effective and peppermint oil was the least effective in both in vitro and in vivo experiments. All three herbal essential oils tested in this study have weak antiparasitic potential against monogenean infections in fish.

Acquired changes in thickness and length of patellar tendon after primary total knee arthroplasty: a prospective ultrasonographic study with over 4 years of follow-up.

Previous literature has reported changes in the length or thickness of the patellar tendon (PT) following primary total knee arthroplasty (TKA). This study aims to determine the structural changes in both the length and thickness of the PT after primary TKA using ultrasound (US) and to investigate the association between these changes and clinical outcomes after a minimum follow-up of 48 months. This prospective study used the US on 60 knees of 32 patients (aged 54-80, mean 64.8±7 years) before and after primary TKA to evaluate changes in both the length and thickness of the patellar tendon. Clinical outcomes were assessed with HSS and Kujala scores. At the latest follow-up evaluation, there was a significant overall shortening of PT by 9.1% (p<0.001), in addition to significant global thickening by 20% (p<0.001). Besides, there was significant thickening by 30% in the proximal 1/3 (p<0.01) and 27% in the middle 1/3 (p<0.01) segments of PT. There was a significant negative correlation between the thickening identified in all three parts of the tendon and both clinical outcome measures (p<0.05). The results show the presence significant changes in PT in terms of length and thickness after primary TKA; in addition, increased thickness in PT was more strongly and significantly associated with inferior clinical outcomes, including functionality and anterior knee pain, than shortness in PT. This study also suggests that the US is a viable, non-invasive method for documenting PT changes in both length and thickness after TKA with serial scans.

PRELIMINARY FINDINGS OF TLR2 AND TLR4 EXPRESSION IN PRETERM NEONATES WITH NECROTIZING ENTEROCOLITIS.

Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality in preterm infants. Despite significant advances made in the prevention and treatment of disease so far, there has not been much change in the rate of mortality and morbidity associated with NEC. Although the factors affecting the development of necrotizing enterocolitis are not yet known precisely, prematurity is thought to be the most important risk factor for the development of NEC. This study aims to determine toll-like receptor (TLR) 2 and TLR4 expression levels in preterm neonates. A total of 50 preterm infants (patient: 42, control: 8) were included in the study. TLR2 and TLR4 expression levels were analysed by the RT-qPCR method. While there was no difference in infants' birth weight (g), gestational age (months), mother's age (years), father's age (years), and WBC (109/L); HGB (g/dL) and RBC (1012/L) were found to be significantly higher in the group with NEC (p<0.05). When TLR2 and TLR4 relative gene expression levels of neonates were evaluated (log2), it was determined that there was a significant difference between the two groups (below 1500 g) (p<0.001). TLR4 relative expression (2^-ddCt, above 1500 g) was higher in the NEC group than in the healthy group, while TLR2 relative expression (2^-ddCt, above 1500 g) was higher in the healthy group. TLR2 and TLR4 have been shown to have prominent roles in the development of NEC in experimental animal models and it would be significant to support this with human studies/animal models for a better understanding of the disease. Thus, it is recommended that future studies be carried out on experimental models that better replicate the human body, and dietary factors should be examined in detail.

The relationship between uric acid levels and graft function in renal transplant patients who discontinued steroid therapy / Relación entre niveles de ácido úrico y función del injerto en pacientes de trasplante renal que interrumpieron la terapia con esteroides

ABSTRACT Introduction: High uric acid levels are commonly encountered in kidney transplant recipients, and can be associated with allograft dysfunction. Our study aims to examine the relationship between UA levels and graft function in patients discontinuing steroids. Methods: In this single-center-retrospective study, 56 patients discontinued steroid therapy from among 678 RT patients transplanted from living donors between 1999-2020 were included. The mean age of the study group was 45.8±8.8 years. Causes of steroid discontinuation, creatinine levels concurrent with uric acid levels before and after steroid discontinuation (mean 3.9 ± 2.1 years), acute rejection numbers, demographics, durations of dialysis and transplantation, medications, laboratory data, human leukocyte antigen (HLA) mismatch numbers, blood-pressure (BP), body mass index, delayed acute rejection (DAR) numbers (3 months post-transplantation) were all recorded. Results: Creatinine and uric acid levels were seen to have increased after steroid discontinuation, there was a significant relationship between them (p<0.001). Statistically significant correlation was found between increased creatinine levels after steroid discontinuation and graft survival with higher HLA mismatch; 39 (69.6%) patients with mismatch ≥2, and 17 patients with mismatch <2 (30.4%) (p=0.049) . No significant relationship was found between DAR numbers before and after steroid discontinuation, and creatinine levels after steroid discontinuation. Conclusion: Per model obtained as a result of multivariate linear analysis, hyperuricemia and HLA mismatch numbers (p= 0.048 and p= 0.044, respectively) are independent predictive factors for graft dysfunction in patients discontinuing steroids. Accordingly, negative effects of modeling should be kept in mind for long-term graft survival in patients who plan to continue with steroid-sparing regimens.

RESUMEN Introducción: Con frecuencia se registran niveles elevados de ácido úrico en receptores de trasplantes renales que pueden estar asociados a disfunción de aloinjerto. El presente estudio tiene por objeto examinar la relación entre los niveles de AU y la función del injerto en pacientes que interrumpieron la terapia con esteroides. Métodos: En este estudio retrospectivo en un solo centro participaron 56 pacientes con interrupción de la terapia con esteroides de un total de 678 pacientes con TR receptores de trasplante de donantes vivos en el período 1999-2020. La edad promedio de la población de estudio fue de 45,8 ± 8,8 años. En el estudio se registraron causas de la interrupción de la terapia con esteroides, niveles de creatinina concurrentes con niveles de ácido úrico antes y después de la interrupción de la terapia con esteroides (promedio de 3,9 ± 2,1 años), números de rechazo agudo, datos demográficos, duraciones del período de diálisis y trasplante, medicación (uso de inmunosupresores, antihipertensivos), datos de laboratorio, números de desajuste del antígeno leucocitario humano (HLA), presión arterial (PA), índice de masa corporal, números de rechazo agudo retardado (DAR) (3 meses después del trasplante). Resultados: Se observó que los niveles de creatinina y ácido úrico aumentaron tras interrumpir la administración de esteroides, con una relación significativa entre ambos (p<0,001). Se identificó una correlación estadísticamente significativa entre el aumento en los niveles de creatinina tras la interrupción de la terapia de esteroides y la supervivencia del injerto con un mayor desajuste de HLA: 39 pacientes (el 69,6%) con desajuste ≥2 y 17 (el 30,4%) pacientes con desajuste <2 (p=0,049). No se encontró una relación significativa entre el número de DAR antes y después de la interrupción del tratamiento con esteroides, así como en los niveles de creatinina tras la interrupción de la terapia con esteroides. Conclusión: De acuerdo con el modelo obtenido como resultado del análisis lineal multivariable, la hiperuricemia y los números de desajuste de HLA (p=0,048 y p=0,044, respectivamente) constituyen factores predictivos independientes para la disfunción del injerto en pacientes que interrumpen la terapia con esteroides. En consecuencia, se deben tener en cuenta los efectos negativos del modelado para la supervivencia del injerto a largo plazo en pacientes que planean proseguir con regímenes con reducción de la administración esteroides.

EVALUATION OF FETUIN-A LEVELS IN THE EARLY STAGE OF AUTOIMMUNE THYROIDITIS.

Context: Fetuin-A is a multifunctional protein and is known to be related to metabolic syndrome, vascular calcification, and inflammation. Objective: The purpose of this study was to determine the effects of serum fetuin-A levels on autoimmune thyroiditis without thyroid dysfunction. Subjects and Methods: This prospective case-control study was performed at the pediatric endocrinology outpatient clinic of a tertiary health institution in Istanbul, Turkey between July 2022 and October 2022. Serum fetuin-A levels were assessed using a human fetuin-A enzyme-linked immunosorbent assay (ELISA) kit (Elabscience Biotechnology, Houston, TX, USA). Results: The study included 86 participants, of which 42 were patients with Hashimoto's thyroiditis (HT) and 44 were controls. Autoimmune thyroiditis without thyroid dysfunction was found to be related to lower plasma fetuin-A levels. There were no statistically significant differences in the neutrophil-to-lymphocyte ratio, fasting blood glucose level, insulin level, or HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) value between the groups. A fetuin-A level of ≤162.22 µg/mL (80.95% sensitivity and 70.45% specificity) was found to support the identification of autoimmune thyroiditis. Conclusions: The findings of our study suggest that autoimmune thyroiditis without thyroid dysfunction is related to lower fetuin-A levels. Low fetuin-A levels are known to be associated with an increased risk of cardiovascular disease, suggesting that careful monitoring is required in patients with low fetuin-A levels.

Venous resection for pancreatic cancer, a safe and feasible option? A systematic review and meta-analysis.

BACKGROUND: In pancreatic ductal adenocarcinoma patients with suspected venous infiltration, a R0 resection is most of the time not possible without venous resection (VR). To investigate this special kind of patients, this meta-analysis was conducted to compare mortality, morbidity and long-term survival of pancreatic resections with (VR+) and without venous resection (VR-). METHODS: A systematic search was performed in Embase, Pubmed and Web of Science. Studies which compared over twenty patients with VR + to VR-for PDAC with ≥1 year follow up were included. Articles including arterial resections were excluded. Statistical analysis was performed with the random effect Mantel-Haenszel test and inversed variance method. Individual patient data was compared with the log-rank test. RESULTS: Following a review of 6403 papers by title and abstract and 166 by full text, a meta-analysis was conducted of 32 studies describing 2216 VR+ and 5380 VR-. There was significantly more post-pancreatectomy hemorrhage (6.5% vs. 5.6%), R1 resections (36.7% vs. 28.6%), N1 resections (70.3% vs. 66.8%) and tumors were significantly larger (34.6 mm vs. 32.8 mm) in patients with VR+. Of all VR + patients, 64.6% had true pathological venous infiltration. The 90-day mortality, individual patient data for overall survival and pooled multivariate hazard ratio for overall survival were similar. CONCLUSION: VR is a safe and feasible option in patients with pancreatic cancer and suspicion of venous involvement, since VR during pancreatic surgery has comparable overall survival and complication rates.

The effect of hysterectomy types on vaginal length, vaginal shortening rate and FSFI scores.

OBJECTIVE: Vaginal length (VL), size and width may show individual differences among women. Hysterectomy causes VL shortening in patients, and this shortening varies according to the type of hysterectomy performed. Some studies in literature have shown that the shortened VL after hysterectomy may cause dyspareunia and have a negative effect on female sexuality. The aim of this study is to compare preoperative and postoperative vaginal lengths, vaginal shortening rate (VSR) not used before in the literature, and postoperative sexual functions according to hysterectomy types. MATERIALS AND METHODS: In the study, which included 136 [55 Total Abdominal Hysterectomy (TAH), 33 Vaginal Hysterectomy (VH), 48 Total Laparoscopic Hysterectomy (TLH)] sexually active patients under the age of 60 who underwent hysterectomy, the patients were divided into three groups according to the type of hysterectomy performed. Groups were compared in terms of demographic variables, preoperative/postop and control VL, vaginal shortening rate and The Female Sexual Function Index (FSFI) scores. RESULTS: Vaginal lengths measured after TLH was longer and vaginal lengths measured after VAH was shorter, the difference was significant (p < 0.01). VSRs were 15.9% in TAH group, 10.9% in VH group and 8.3% in TLH group (p < 0.05). Total FSFI score was higher in TLH group than TAH and VH group (p < 0.01). Group of VSR>15% had statistically significantly lower FSFI scores in lubrication, orgasm, pain and total score than both the VSR<10% group and the VSR 10-15% group (p < 0.05). CONCLUSION: Calculating the VSR after hysterectomy instead of postoperative VL measurement will allow us to obtain more individual and accurate results in predicting postoperative sexual functions. We found that TLH is the best hysterectomy method in terms of preserving sexual functions due to less loss of vaginal tissue in the postoperative period from these three techniques that are frequently.

Non-functional recurrent pituitary adenoma with intracranial metastasis-Pituitary carcinoma: A case report and review of the literature.

INTRODUCTION: Pituitary carcinomas are rare, with only a few case reports to date. We present a null cell type non-functioning pituitary carcinoma (NFPC) with intracranial metastases and a review of the literature. CASE REPORT: A 56-year-old male with a history of an aggressive pituitary adenoma was admitted. Initial MRI highlighted a large intracranial mass with leptomeningeal involvement, simulating meningioma. Based on his previous pathology report of the sellar mass, a diagnosis of null cell type non-functioning pituitary carcinoma has been made. CONCLUSIONS: An aggressive recurrent pituitary tumor with suprasellar and/or cavernous sinus invasion is the main characteristics of the NFPC. Single or multiple enhancing dural-based mass(es) mimicking meningioma is the most common MRI finding. The proof of malignancy is the same histopathological features of the recurrent aggressive pituitary tumor in the metastases. The histology alone is not distinctive in terms of malignancy. Most patients require a combined surgery, radiotherapy and chemotherapy.

Evaluation of coronavirus disease (COVID-19) awareness of patients undergoing dental interventions in Turkey.

AIMS: We aimed to objectively assess the COVID-19 awareness of the patients requiring dental interventions in our dental clinic by utilizing a newly generated questionnaire, which may serve helpfully in the hard battle against the pandemic in our country. MATERIALS AND METHODS: This study included 306 volunteer adults who applied to our dental clinic for dental interventions during the early days of COVID-19 outbreak in Turkey. All patients responded to a newly created questionnaire composed of four sections with 19 questions those mostly assessing the social and demographic details; like the participant's age, gender, marital status, education status, medical history, basic dental hygiene habits, occupation, and general information about the COVID-19 infection and its protection methods. RESULTS: The outcomes of 306 participants revealed that their gender, age, and education status showed significant distinctions about the dissemination of coronavirus via dental interventions. Higher education status was linked to a loftier level of social awareness about the COVID-19 infection and its potential associations with dental interventions. It was observed that the participants were unsatisfactorily cautious against the COVID-19 infection and its dissemination pathways in their social environment, particularly in the specific case of systematic diseases and preventive measures. The primary way of obtaining information about the COVID-19 infection was the electronic websites. CONCLUSION: Deplorably, accentuating the urgent need for further intensive training programs on the relationship between the systemic diseases and COVID-19 infection, and explicit daily care methods in the social environment.

In vitro contact guidance of glioblastoma cells on metallic biomaterials.

Cancer cells' ability to sense their microenvironment and interpret these signals for the regulation of directional adhesion plays crucial role in cancer invasion. Furthermore, given the established influence of mechanical properties of the substrate on cell behavior, the present study aims to elucidate the relationship between the contact guidance of glioblastoma cell (GBM) and evolution of microstructural and mechanical properties of the implants. SEM analyses of the specimens subjected to 5 and 25% of plastic strains revealed directional groove-like structures in micro and submicro-sizes, respectively. Microscale cytoplasmic protrusions of GBMs showed elongation favored along the grooves created via deformation markings on 5% deformed sample. Whereas filopodia, submicro-sized protrusions facilitating cancer invasion, elongated in the direction perpendicular to the deformation markings on the 25% deformed sample, which might lead to easy and rapid retraction. Furthermore, number of cell attachment was 1.7-fold greater on 25% deformed sample, where these cells showed the greatest cellular aspect ratio. The directional attachment and contact guidance of GBMs was reported for the first time on metallic implants and these findings propose the idea that GBM response could be regulated by controlling the spacing of the deformation markings, namely the degree of plastic deformation. These findings can be applied in the design of cell-instructive implants for therapeutic purposes to suppress cancer dissemination.

Protective effect of Coenzyme Q10 on oxidative ovarian and uterine damage induced by methotrexate in rats.

Methotrexate (MTX) has toxic effects on the uterus and ovaries via oxidative stress. Coenzyme Q10 (CoQ10) is an important component in electron transport in the mitochondria and an antioxidant in cellular metabolism through the inhibition of lipid peroxidation. The aim of this study was to investigate the preventive effects of CoQ10 on MTX-induced utero-ovarian damage and oxidative stress in rats.In this experimental study, 30 albino Wistar female rats were divided randomly into three groups. Once a day for a month, 10 mg/kg of CoQ10 was orally administered to the rats in the MTX+CoQ10 group, while the same volume of olive oil was administered orally to the other two groups. One hour thereafter, 20 mg/kg of MTX was injected intraperitoneally into the rats in the MTX and MTX+CoQ10 groups; the remaining group was the control. At the end of the month, biochemical and histopathologic examinations were performed on the extracted uteri and ovaries. In the uterine ovarian tissues of the animals in the MTX group, there was an increase in oxidative stress mediators and a decrease in antioxidant and anti-inflammatory mediators, but these trends were reversed in the MTX+CoQ10 group, demonstrating the antioxidant effects of CoQ10. MTX leads to oxidative stress-related ovarian and uterine injury, and CoQ10 may be useful for protecting ovarian and uterine tissue from such injury.

Retrospective evaluation of cone-beam computed tomography findings of odontogenic cysts in children and adolescents.

BACKGROUND: Odontogenic cysts develop from the epithelium of dental structures and generally grow slowly. In children and adolescents, cysts usually grow faster than adults and require much knowledge for diagnoses and treatments. AIMS: This study aimed to determine the diagnosis and treatment of odontogenic cysts in different age groups by evaluating the type of lesions, age, gender, and anatomical distribution of odontogenic cysts seen in children and adolescents by cone-beam computed tomography. MATERIALS AND METHODS: A total of 42 odontogenic cysts (radicular, dentigerous cyst, and odontogenic keratocyst) were determined in children and adolescents aged 7-18 years. Cone-beam computed tomography images of odontogenic cysts were analyzed in terms of types, age, sex, anatomical location, height, width, depth, scalloped borders, lesion shapes, tooth displacement, root resorption, and association with an unerupted tooth. RESULTS: There was a significant correlation between odontogenic cyst types and age groups, scalloped borders, lesion shape, tooth displacement, root resorption, and association with an unerupted tooth. CONCLUSION: When odontogenic cysts seen in children and adolescents are examined with cone-beam computed tomography, the radicular cyst was the most common form and was predominated in the 13-18 years age group and in boys. Differences in terms of scalloped borders, lesion shape, tooth displacement, root resorption, and association with unerupted teeth were noticed. The knowledge of the distribution and properties of odontogenic cysts in pediatric patients will help diagnose the lesions during clinical and radiological examinations and make appropriate treatment planning.

Effects of two types of energy restriction on methylation levels of adiponectin receptor 1 and leptin receptor overlapping transcript in a mouse mammary tumour virus-transforming growth factor-α breast cancer mouse model.

The role of adiponectin and leptin signalling pathways has been suggested to play important roles in the protective effects of energy restriction (ER) on mammary tumour (MT) development. To study the effects of ER on the methylation levels in adiponectin receptor 1 (AdipoR1) and leptin receptor overlapping transcript (Leprot) genes using the pyrosequencing method in mammary fat pad tissue, mouse mammary tumour virus-transforming growth factor-α (MMTV-TGF-α) female mice were randomly assigned to ad libitum (AL), chronic ER (CER, 15 % ER) or intermittent ER (3 weeks AL and 1 week 60 % ER in cyclic periods) groups at 10 weeks of age until 82 weeks of age. The methylation levels of AdipoR1 in the CER group were higher than those in the AL group at week 49/50 (P < 0·05), while the levels of methylation for AdipoR1 and Leprot genes were similar among the other groups. Also, the methylation levels at CpG2 and CpG3 regions of the promoter region of the AdipoR1 gene in the CER group were three times higher (P < 0·05), while CpG1 island of Leprot methylation was significantly lower compared with the other groups (P < 0·05). Adiponectin and leptin gene expression levels were consistent with the methylation levels. We also observed a change with ageing in methylation levels of these genes. These results indicate that different types of ER modify methylation levels of AdipoR1 and Leprot in different ways and CER had a more significant effect on methylation levels of both genes. Epigenetic regulation of these genes may play important roles in the preventive effects of ER against MT development and ageing processes.

Role of acoustic radiation force-based elasticity imaging in endometrium pathologies.

BACKROUND: Ultrasonography is difficult to distinguish between endometrial pathologies and often requires curettage. ARFI (Acoustic Radiation Force-Based Elasticity Imaging) is a new ultrasonography elastography method. Using ARFI, it is possible to obtain information about the likelihood of the tissue benign or malignant. AIM: The aim of this study is to evaluate the contribution of ARFI to differentiate endometrial pathologies in hysterectomy specimens. SUBJECTS AND METHODS: Our study was prospectively, January-May 2017, performed in randomly 45 cases of 41-91 years of age (mean 58.3 years) who have decided to have hysterectomy. Hysterectomy was performed for uterine prolapse and endometrial hyperplasia in elderly patients and menorrhagia in young patients. Pathology results were compared with ARFI values and endometrial thickness. ANNOVA test was used for the comparison of ARFI values. RESULTS: Pathology revealed 14 cases of endometrial atrophy, 11 cases of proliferative phase, 10 cases of polyp, 6 cases of endometrial hyperplasia, and 4 cases of endometrium cancer. There is a statistically significant difference between mean ARFI values of endometrium, subendometrium, and myometrium of the groups (P < 0.05). There was a statistically significant difference between the mean endometrial thickness of the groups (P < 0.05). CONCLUSION: Endometrium ARFI contributes to the differential diagnosis of endometrial pathologies. Subendometrial and myometrial ARFI values decrease in polyps and increase in hyperplasia. Our study shows that the addition of subendometrium ARFI to gray-scale sonography before deciding on invasive procedures in endometrial pathologies may improve diagnostic accuracy. We concluded that further in vivo studies will establish the usefulness of this technique for preoperative diagnostic measures.